QUITTOR. 389 



pus cavity below the opening, a cartilaginous quittor is in the course 

 of development. 



Treatment. — Hot baths and poultices are to be used until the pres- 

 ence of pus can be determined, Avhen the tumor is to be opened with 

 a knife or sharp-pointed iron heated white liot. The hot baths and 

 poultices are now continued for a few days or until the entire slough 

 has come away and the discharge is diminished, when dressings 

 recommended in the treatment for cutaneous quittor are to be used 

 •until recovery is completed. In cases where the discharge comes 

 from a cleft between the upper border of the hoof and the coronar}^ 

 band, always pare away the loosened horn, so that the soft tissues 

 beneath are fully exposed, care being taken not to injure the healthy 

 parts. This operation permits of a thorough inspection of the dis- 

 eased parts, the easy removal of all gangrenous tissue, and a better 

 application of the necessary remedies and dressings. The only objec- 

 tion to the operation is that the patient is prevented from being early 

 I'eturned to work. 



When the probe shows that pus has collected under the coffin bone 

 the sole must be pared through, and if caries of the bone is present 

 the dead parts cut away. After either of these operations the wovmd 

 is to be dressed with the oakum balls, saturated in the bichloride of 

 mercury solution, as previously directed, and the bandages tightl}' 

 applied. Generally the discharge for the first two or three days is so 

 great that the dressings need to be changed every twenty-four hours; 

 but when the discharge diminishes, the dressing may be left on from 

 one to two weeks. Before the patient is returned to work, a bar shoe 

 should be applied, since the removed quarter or heel can only be made 

 perfect again by a new growth from the coronary band. 



Tendinous or cartilaginous complications are to be treated as 

 directed under those headings. 



CARTILAGINOUS QUITTOR. 



This form of quittor nuiy commence as a primary inflammation of 

 the lateral cartilage, but in the great majority of cases it appears as a 

 sequel to cutaneous or subhorny quittor. It may affect either the fore 

 or hind feet, but is most commonly seen in the former. As a rule, it 

 attacks but one foot at a time, and but one of the cartilages, generally 

 the inner one. It is always a serious affection for the reason that, in 

 manj^ cases, it can only be cured by a surgical operation, requiring a 

 thorough knowledge of the anatomy of the parts involved and much 

 surgical skill. 



Causes. — Direct injuries to the coronet, such as trampling, pricks, 

 burns, and the blow of some heavy falling object which uuiy puncture, 

 bruise, or crush the cartilage, are the conunon direct causes of carti- 

 laginous quittor. Besides being a sequel to the other forms of quittor. 



